Remote Admissions Specialist
4 weeks ago
Related experience preferred.
Strong knowledge base surrounding substance abuse and mental health conditions and Treatment is preferred.
**Purpose of Position**
- The role of the Utilization Review Admissions Specialist is to obtain initial insurance authorizations for patient care and treatment. This individual will be assigned cases each day and be expected to work faxable items on the weekend for the insurance companies that are not open for live authorizations.
- Weekend admissions coordination may also include prioritizing incoming cases and preparing documenation or cases for the admissions team to begin working on Monday morning.
**Responsibilities**
- Perform utilization review functions including obtaining pre-authorization and obtaining patient updates
- Maintain accurate and timely documentation
- Develop collaborative relationships with insurance care managers and healthcare providers, in order to provide clients with expeditious delivery of service.
- Developing strong relationships through frequent communication and interaction.
- Function as a member of the Utilization Review Team to ensure that all daily responsibilities are met.
- Respond to insurance denials through the appeals process when appropriate.
- File retrospective reviews and medical necessity appeals as needed.
**Benefits**
- Paid time off after first 90 days
- Medical, Dental, and Vision Insurance after 60 days
- 401k with matching after 1 year of employment
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